Lung Cancer

Lung cancer is the number one cause of cancer-related death, responsible for roughly one third of all cancer fatalities. Tobacco smoking is the major cause of lung cancer. Consequently, one of the most effective ways to decrease lung cancer mortality is to decrease tobacco use. In addition, close monitoring of individuals who continue to smoke may permit early detection of lung cancer.

The multidisciplinary lung cancer program at Montefiore Medical Center and the Albert Einstein College of Medicine focuses on the development of innovative approaches for the early detection and intervention of lung cancer. In addition, the program studies new strategies for the treatment of advanced disease, emphasizing the integration of new molecular therapies in the existing modalities - surgery, radiotherapy and chemotherapy.

Most patients diagnosed with lung cancer at Montefiore Medical Center are referred for a second opinion from other Centers. Patients' diagnoses are reviewed at a weekly multidisciplinary conference at the Weiler campus. A team of pathologists, pulmonologists, radiologists, thoracic surgeons, and medical oncologists discuss the findings and recommend a treatment plan. Innovative clinical research protocols that utilize the latest and most promising agents alone or in combination are offered to appropriate patients. Dr. Steven Keller, chief of the Division of Thoracic Surgical Oncology, coordinates the conference.

Spiral CT of the chest is more sensitive than a regular chest-X ray in detecting lung cancer, at a time when the cure rate may be as high as 90%. Montefiore Medical Center is establishing a collaboration with Weil/Cornell Medical College to screen individuals at risk of lung cancer because of a significant past smoking history. These studies will be expanded in the future to include patients who have had previous head and neck cancer, another cancer directly related to tobacco smoking.

Innovative Research

Researchers at Montefiore Medical Center and the Albert Einstein College of Medicine are actively working on studying early genetic damage to the lungs in youths with a <5 years smoking history. The objective of this study is to select young people who demonstrate a greater probability of developing lung cancer later in their lives. These individuals may then be offered early and intensive preventive and therapeutic interventions that include smoking cessation and the use of agents given by inhalation that directly go to the areas damaged by tobacco.

Innovative Treatment

The Lung Cancer Program at Montefiore Medical Center and the Albert Einstein College of Medicine is testing innovative treatments for lung cancer and pre-malignant conditions by targeting specific molecular abnormalities within the tumors. Dr. Perez-Soler, chairman of the Department of Oncology and other clinicians at Montefiore Medical Center and the Albert Einstein College of Medicine have pioneered the clinical development of many of these agents. They are currently investigating their use in a variety of stages of lung cancer, either using the new agents alone or in combination with more traditional treatment modalities. Emphasis is placed on the development of signal transduction inhibitors that block the growth of tumor cells. Some of these compounds have shown very promising antitumor activity in studies conducted by Montefiore Medical Center clinical investigators.

The new compound Tarceva, an EGFR inhibitor, is one such agent. It will be given in combination with chemotherapy prior to surgical removal of the tumor. Iressa is a similar drug being given to patients with very advanced disease, either alone or in combination with chemotherapy. Another completely new agent being investigated in patients with advanced disease is the compound PS341. This drug prevents the cell from disposing of old and useless proteins, thus causing cell death.

Patients are referred back to their referring physicians' offices after completing the program.